AI and techno totalitarism
by Dr Louis Fouché
Slides available here:
https://docs.google.com/presentation/d/1w1RcsstTfd_cmnSIqgCbH6r283sVstp2-_Y8wZPPVQ8/edit?usp=sharing
Summary:
In this presentation, Dr. Louis Fouché, an intensivist with expertise in medical ethics, explores the philosophical and ethical dimensions of the technological disruption caused by artificial intelligence (AI) in the medical field. He examines both optimistic and pessimistic perspectives on AI, emphasizing the risks of technology expropriating medical decision-making. The presentation delves into the aggressive promotion of AI, the implications of European Commission regulation, and the need to resist total digital transformation. Dr. Fouché warns against the loss of human autonomy and underscores the importance of resisting an omnipresent digital reality.
Dans cette présentation, le Dr Louis Fouché, spécialiste en réanimation et en éthique de la santé, aborde les aspects philosophiques et éthiques de la perturbation technologique provoquée par l’intelligence artificielle (IA) dans le domaine médical. Il explore les perspectives optimistes et pessimistes de l’IA, soulignant les risques d’expropriation des décisions médicales par la technologie. La présentation examine également la propagation agressive de l’IA, les implications de la régulation de l’IA par la Commission européenne, et la nécessité de résister à une transformation numérique totale. Dr Fouché met en garde contre la perte de l’autonomie humaine et souligne la nécessité de résister à une réalité numérique omniprésente.
Slide I
First I want to thank the organizers, the contributors, and our courageous Romanian hosts
who dare to organize this necessary feedback. I hope it shall spread everywhere more
widely.
This painting named Théatre d’opéra spatial / Spatial opera theater was made by the
Midjourney generative AI from the prompts of the artist Jason Allen. He was granted a prize,
then accused of cheating. Who won ? The artist or the AI ?
Slide II
I’m Dr Louis Fouché intensivist, with several university degrees in ethics and anthropology of
Health. My field is the criticism of the technologic system surrounding our medical practice.
I will explore philosophical and ethical issues related to the technological disruption of
Medicine, by artificial intelligence.
Slide III
I have no conflict of interest. I don’t have any public political affiliation. I do not speak in the
name of our hosts, but in my own name.
Slide IV
This presentation is not made from a genuine organic human intelligence juice. I used all
these applications. I even spent time with the chatGPT chat box, trying multiple prompts. AI
is already knitted in our skin and brain ?
Slide V
The simplistic presentation is the following: The pros versus the cons. The first ones
consider AI as a brilliant opportunity to reduce our mistakes. They want to optimize our
medicine. They are fascinated by the efficiency, the speed, the seduction, the comfort, but
mostly by the power and the business opportunities given by the mastering of the data.
On the other side, the pessimistic ones see the Humans cursed by their arrogant technology
and Hubris. Hubris, for the Ancient Greeks is the will of potency, the fantasy of pretending to
be god instead of god.
Hubris is always followed by Nemesis. Nemesis is the wrath of the Gods. The Prometheus’
doom. The human punishment for his pride. They consider AI as one tool for the
self-destruction of our civilization. Eschatologic and human ontological concerns surrounding
autonomization of the technology are their central problem.
In 1956, Gunther Anders, In the obsolescence of man, after the disaster of the nuclear
bombing, and the beginning of the civil use of nuclear fission energy, described the
unrepresentability of the disaster. This is the impossibility for the humans to foresee the
disaster which is coming, resulting from their arrogance and lack of responsibility.
Slide VI
The optimistic ones see AI as a kind of technological cultural Revolution, which is gonna
change everything. As for the medicine, AI will assist the overwhelmed doctors, and make
them earn time and money. It will get rid of all the tedious administrative work, and enable
personalized and inclusive medicine and care. They’re prompting us to become the brand
new augmented human. Life shall be optimized by digital technology, just like a user
experience.
Slide VII
But this sounds like an alluring narrative. This is part of a disruption scenario. Actually the AI
technology and the digital world are being very harshly and very aggressively pushed.
Matthew Crawford described in his book contact the overwhelming economic War for our
attention. Attention is constantly disrupted by the data industry, and drawn away from the
essential. Our digital devices constantly suck information, and provide constant propaganda.
It is consistent with the “telescreen” described by Orwell in his 1984 book.
Slide VIII
Generative AI use probabilistic models to create new data, based on the examination of the
existing examples.
They are expert systems, making algorithmic decisions, from the information granted by the
connected databases. They are interfaced with humans through natural language, which is
called NLP.
They generate content automatically with their own logic. Neuronal network processes are
self learning. You don’t really know how they made their decision. They are grounding on the
available data.
So the big big big issue is that they need to be fed with big big big data. Who is the
master of the Data is the real question.
Slide IX
There’s a massive propaganda and funding in medicine over those generative AI and digital
transition of medicine. More than 60,000 articles have been published in pubMed on the
topic of AI and medicine and more than 12,000 in 2023, at a logarithmic progression rate.
Whatever your topic is, you are doomed to make a startup with digital tech, if you want your
research to be funded. All of those articles are dealing with the same keywords:
personalized and precision medicine, future, innovation and blah blah blah and blah blah
blah.
Slide X – XI – XII – XIII – XIV – XV
Here is a list of AI medical applications, generated through ChatGPT. AI does the
administrative tasks, for instance making the reports for the doctors automatically after a
consultation, or generating drafts for the referral letters to the colleagues, or managing the
declaration to the healthcare insurance and things like that. So they are kind of facilitating all
the boring work.
A lot of them are also used to do the patient’s followup after surgery through smartphones,
and already implemented in everyday practice. They are also used in medical research to try
and find new medication or repurpose old medications. They are used in the image
diagnosis, helping the radiologists daily. They gather symptoms and formulate hypotheses
for the diagnosis, proposing what should be the different lab tests performed. They are also
used in the treatment decision making. For instance in analyzing the genomic and clinical
data to personalize treatment in cancer.
They are used for surgery to provide an intuitive system of manipulation of the surgery
robots, in ventilators to accelerate the weaning of mechanical ventilation in intensive care.
They close loop glycemia and insulin distribution. They are even used in mental illnesses
and addictology.
With the right AI, pharmacists in France can now officially pretend to be medical doctors if
they own the validated application, giving automated answers and prescriptions for ten usual
diseases.
Slide XVI
For the doctors, there’s a prophecy, and a curse. It has been summed it up in an article titled
:
“Artificial intelligence won’t replace doctors, but doctors who use artificial intelligence will
replace those who don’t”…
How come we cannot discuss or refuse AI disruption ?
Are we so sure AI is not gonna get rid of the doctors for good and create Uber-doctors?
Slide XVII
This article in the JAMA Internal Medicine marks a cornerstone in April 2023. It has been
extensively relayed and commented on by the mainstream media. Physicians are compared
to a chatGPT chat box for answering the patients’ questions. The chatbox answers were
judged significantly more empathic and more qualitative than the physicians’ answers, which
is quite embarrassing and inconvenient.
Slide XVIII
This narrative is part of an intention. This intention is to raise a speculative bubble over
Health transformation, and to progressively expropriate doctors and healthcare providers
from the decision making process.
Appropriation and expropriation has been shown by Mehdi Belaj Kacem, as a particular trait
of human nature. Humans appropriate everything in huge proportions, and thus expropriate
at the same time. Big data and Big Tech are actually expropriating the doctors and the
healthcare regulators and providers, and the citizens from the loop.
What is happening with AI and digital revolution in health is a shock doctrine imposed
on medicine.
Shock strategy and disruption were described by Naomi Klein and Berner Stiegler. If one
wants to conquer a market, he should inflict a big shock in the system before, and collapse
the regulation and the institutions of this system. Then he will take control over the damaged
system and the market, by rebuilding the regulation. AI is a weapon in a holy economic war,
conquering Health’s market.
Slide XIX
The goal of Digital technologies is an automated controlled world. The totally controlled
perfect city has been described by Thomas Hobbes in the Leviathan. The city is ruled by
numbers and science, and everything is perfectly optimized. The streets have the right
dimensions, accidents are impossible. Everything is ruled, fluent and automated. 15 minute
towns were already fantasized.
Jeremy Bentham, a utilitarian thinker, modelized a place where nothing bad should happen.
This place would be called a panopticon, (see everything) where the walls would be
transparent, and one central guardian would see everything anytime. This place under
absolute control, because of absolute centralized information, would be for Bentham the best
ideal prison. He spent his fortune and the rest of his life building panoptic prisons.
Michel Foucault, french thinker, related totalitarian regimes to the installation of a panoptic
surveillance over the citizens. A society of total surveillance is precisely being set up using
AI and digitalization.
Slide XXI
The numeric steering of the society has been theorized in the late 40’s by the Macy
Conferences, and the emergence of cybernetics. Cybernetics comes from the ancient greek:
Kubernetes, designating the steersman, the governor. Norbert Wiener formulated the
principles of the cybernetics, which are still ruling the development of AI nowadays.
Cybernetics explore the communication, control, and regulation of systems, whether
biological, mechanical, or social. It questions how systems process information, adapt to
changes, and maintain stability, through feedback loops.
Slide XXII
It has been applied in various fields, ranging from biology to meteorology, engineering,
trading and now artificial intelligence and medicine. It’s all about control and neverending
suppression of the mistake. It is preoccupied with efficiency, with performance, with
immediacy.
On the overall, it’s the continuation of the industrial logic consisting in the replacement of the
artisanal work by a data-driven industrial machine, which maximizes the profit and
progressively separates the human from the concrete.
Slide XXIII
Cybernetic’s steering progressively and constantly led to a loss of relationship with reality,
and a despise for the human frailty. It is a paranoid search for perfection. Cybernetics is thus
the perfect tool for totalitarian paranoid regimens.
It actually happened with IBM and the Nazi Reich. IBM made a strategic alliance with the
Nazi Germany and provided the nazi with tabulation machines. They contributed extensively
to the census of the Jewish people. The IBM-Dehomag applications have been used for
facilitating the persecution and the genocide of the Holocaust.
Slide XXIV
Artificial intelligence and digitalization need all the data to be efficient. They need to
duplicate the world as data. Progressively, data capturing devices invaded our lives, starting
with vidéocameras till our cell phones, constantly listening, watching and registering GPS
position, temperature, time, interaction with the command bar, keywords used…
Everything in the real world around us is now digitized into data, collected in real time by the
connected devices surrounding us.
Next step is to transform the body into data. In medicine, this is called quantified self. The
frontier between the pathologic and the normal collapses. This big data is actually feeding
the Techno Monster to provide a comprehensive representation of the world.
Slide XXV
If one can see and know everything. He cannot be surprised, he can predict everything. The
big data will see things that you can’t see. It relies on a necessarily totalitarian data
collection. This is the power of Aléthéia. Aléthéia meant the truth of not forgetting anything,
the truth of the unveiling.
When you watch in the air in the morning to see what’s going to be the weather today, you’re
completely outdated and insufficient, and overtaken by the technology who is scanning the
clouds, monitoring temperatures and pressure in the high atmosphere in real time. Weather
Forecast offices have the data and the Alethéia, and you are expropriated from your capacity
of predicting the weather.
There’s a loss of the human capacity to gather and interpret the signs. This is the same for
the doctors when a digital system is registering real time data from a whole patients’
population. The signs and symptoms you see, what you think and plan, as a single doctor,
turns completely outdated and obsolete.
Slide XXVI
The actual truth is now known because the concrete facts were duplicated as a numeric and
digital world, in which the data-keeper can request, organize and cross correlate the data. If
all the data is gathered and represents the world better than any of us could do. What should
be done is up to the ones who control the data. Data mastering provides a prescriptive
power on the concrete world.
Waze is a good example. If it was only connected to one car, it would be inefficient. To be
mostly efficient it must be connected to every car. And then it prescribes each driver with its
specific route planning, creating traffic jams if it wants…
Slide XXVII
AI and the big data steering introduce a disruption in epistemology. Epistemology is about
what is truth and knowledge. Those generative AI are cross correlating the information. They
gather the concepts without theoretical or coherence questioning.
The trial – error method of proof, which was the usual process in science, no longer exists.
Knowledge is no longer related to a concrete experience. It is relying on the ghost of the
experience, gathered in the databases. The truth is what has been cross correlated from the
registered databases.
But data can be biased, suppressed or created by automated prescription, propaganda or
censorship. Thus automated Prescription, Bias, Propaganda and Censorship become the
knowledge and the truth…
Who is the door keeper between data and applications is the second question ? These
gatekeepers are the factcheckers, their financial masters, the medias… ? We are
exxpropriated.
We have observed the consequences of such decorrelation from the reality during the
covid…
Slide XXVIII
The underlying intention is to get rid of mistakes. Humans make mistakes. AI shall logically
get rid of the human eventually ? The superman of Nietszche transforms into the absurd
fantasy of the transhuman, riding the AI for his domination over hazard and death.
Slide XXIX
Those Technologies are interstitial. They’re taking place in our life extensively. Have you
ever tried to get rid of your Gmail or your smartphone ? It is nearly impossible now. It is a
metastasized cancer.
Our medicine, and more widely our society is just like a patient in intensive care. The more
he has tubes, needles, catheters, machines, the less he is alive, the less he is autonomous,
the less he is conscious. The path toward healing never consists in adding more artifacts.
On the contrary, getting back to autonomy and life consists in being weaned off from the
different life supporting devices.
Slide XXX
Recently a change in the dominant narrative over AI has happened. Mainstream media
published the emotions and sorrows of the leaders of the Big Tech. Mo Gwadat, an ex
executive in the Google team, said generative AI was the biggest mistake of his life.
Geoffray Hinton, presented as the Godfather of the AI, said he regretted the invention and
assessed that it could be a domination tool. It has been widely relayed and published in the
mainstream media.
Is it a part of the disruption scenario ? After the honeymoon, now it is the threat and the fear
project on the front of the scene. And it is presented as the responsibility of the technology
itself for the drawbacks. Which is a lie. It is technocracy owner’s responsibility.
The fearful narrative may justify all the damages to our freedoms. Just like in Covid. Is the AI
narrative switch intended to blind us over the real billionaires behind the technology, and
their fascination for power and control ? Conveniently, fear may justify regulation, forbidding
open source AI, or forbidding any kind of unauthorized uses, controlling the validity of the
data by factcheckers, designating convenient data keepers.
An automated World is being set up by financial powers investing in Tech. It has no more
relation with the real. It pretends to create knowledge, truth and reality, and prescriptions for
any acts of our lives.
Slide XXXI
The European commission committed a regulation text for AI in 2019. The Artificial
Intelligence Act. At first reading it appears to regulate the uses of AI. But the EU is the tool of
multinational companies to disrupt people’s democratic regulations. We should read and
read this text again, and read between the lines. The regulations for medical AI are mostly
declarations of intention and shy, and the promise is more rules and contraints.
We live in an illusion, like in Plato’s cave or in The Truman Show. Algorithms have taken a
rising space in our lives. It sets the way for the administration of our everyday life, and must
end in a totalitarian power.
Conclusion
Are we already transhumanistic avatars ? Those last three years, we all happened to spend
an increasing amount of time on the computers and smartphones, using the Zoom
application, and living increasingly in the digital connected world. Big illusion is supplanting
the real world. Big Data and Big tech are supplanting Big pharma, democratic regulation and
the doctors, and grab the Big Money and the Big Power.
Is there a path for resistance and resilience ? I think we are the path. The resistance to the
Covid narrative opened the way. There is a rationality War going on. Do we want to let
technocracy control and predict everything ? Or do we accept frailty, insufficiency, delay,
mistake, freedom and corollary responsibility as a gift of our human nature ? There is an
ontological question behind that.
May we not let the reign of silicon rule our lives.
Covid and Digital disruption destroyed Innocence, Fraternity, Medicine, History, Science,
Truth, Knowledge, Freedom, Autonomy, and Democracy. We shall now work hard to repair.
It’s worth a lifetime.
A Romanian doctor told me Romanian people could repair everything.
Let’s get to work !
And Let’s get rid of this huge Théatre d’opéra spatial / Spatial opera theater and get back to
concrete reality.
Thank you very much for your attention.
